1. Field of the Invention
The present invention relates generally to laparoscopic and similar surgical procedures, and more particularly to a hemostat delivery system and method for using same in a laparoscopic procedure.
2. Description Of The Prior Art
Laparoscopic, arthroscopic and endoscopic cannulae and surgical procedures are known. Initially, it should be understood that the delivery system of the present invention is independent of the nature of the specific medical procedure being performed. Thus, "laparoscope" is used here as a generic term which is meant to encompass other similar type devices including the arthroscope and endoscope. Similarly, references herein to a "laparoscopic" procedure should be understood as encompassing "arthroscopic" and "endoscopic" procedures as well.
Normally, preparatory to initiating a laparoscopic procedure, several cannulae are inserted into the body. These cannulae serve as channels through which various instruments are inserted One generally serves to pass the laparoscope itself (i.e., the fiber optic device which carries light to the site for illumination and back from it for viewing) Another can serve as the gas delivery/ventilating channel and the rest will generally serve as working channels to pass the implements used to perform the procedure.
Laparoscopes have been employed to perform a wide range of surgical procedures. Many of these procedures can result in a considerable amount of internal bleeding. For example, recently a laparoscopic procedure has been developed for removing gall bladders, which procedure requires severing the vascularized stem containing the artery that supplies blood to the gall bladder as well as numerous arterioles, venuoles, and capillaries. The larger, major vessels are ligated or tied off via clips introduced through a working channel or otherwise, and cautery is used to seal off any remaining bleeding of the ligated vessels and as much of the bleeding "bed" as possible. Cautery has its own risks and limitations which can include incomplete or irregular sealing of vessels and which can contribute to problems of postoperative bleeding, one of the three most significant complications of the procedure. In order to avoid the drawbacks of cauterization and other similar procedures, the present invention uses collagen.
Of course, it is well known to use collagen to stanch bleeding. Specifically, in traditional surgical procedures, hemostasis initially is achieved by mechanical means, i.e., collagen is applied with direct mechanical pressure around the bleeding site. Immediately, the collagen material begins to interact with clotting elements in the blood and tissue of the site and initiates biochemical hemostasis. Once the hemostasis becomes sufficiently strong, e.g., strong enough to withstand blood pressure at the site, mechanical pressure can be removed.
Thus, bleeding during traditional surgical procedures, which often occurs as a result of cutting minor arteries, veins and capillaries, generally can be stanched by direct manual application of a hemostatic material, such as collagen, and digital pressure through the surgical opening. However, when surgery is performed by a laparoscopic procedure, for example, when removing a gall bladder, access to the bleeding site is far more restricted.